Provider Demographics
NPI:1992770630
Name:COTLIAR, ARTHUR MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:MICHAEL
Last Name:COTLIAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ARTHUR
Other - Middle Name:M
Other - Last Name:COTLIAR, MD PLLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:635 WEST 165TH STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-2241
Mailing Address - Fax:212-305-3266
Practice Address - Street 1:635 WEST 165TH STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2241
Practice Address - Fax:212-305-3266
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136628207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5447800001OtherMEDICARE DMEMAC
NY00711546Medicaid
NY00711546Medicaid
5447800001OtherMEDICARE DMEMAC